General practice after-hours incentive funding: a rationale for change

Area of Science:

• Health Services Research
• General Practice Funding Models
• Primary Care Policy

Background:

• The Practice Incentives Program (PIP) introduced after-hours incentive funding in 1998.
• A 2010 audit revealed significant non-compliance with PIP after-hours funding components.
• The audit highlighted the need for secondary data to verify practice compliance.

Purpose of the Study:

• To analyze the drivers of the 1998-2013 PIP after-hours funding mechanism.
• To inform the development of a fair, transparent, and auditable funding scheme for Tasmania.
• To evaluate the appropriateness of current funding determinants.

Main Methods:

• Examination of the Practice Incentives Program (PIP) after-hours incentive funding mechanism drivers from 1998 to 2013.
• Analysis of factors influencing after-hours attendances in Tasmanian general practices.
• Assessment of after-hours attendances to residential aged care facilities.

Main Results:

• Increasing practice remoteness, not practice size or claimed stream, was the primary driver of urgent after-hours attendances in Tasmania.
• After-hours attendances to residential aged care facilities were concentrated in urban areas, irrespective of practice location or stream.
• The PIP after-hours funding mechanism did not adequately support practices providing after-hours care, potentially creating perverse incentives.

Conclusions:

• The current PIP after-hours funding mechanism is inequitable and requires reform.
• A new funding model should prioritize support for unavoidable burden and care provided to residential aged care facilities.
• Funding based on claimed provision is inappropriate and should be reconsidered.